Impact of genetic variants on major bleeding after percutaneous coronary intervention based on a prospective multicenter registry

Jung-Joon Cha, Hyung Joon Joo, Jae Hyoung Park, Soon Jun Hong, Tae Hoon Ahn, Byeong-Keuk Kim, WonYong Shin, Sung Gyun Ahn, JungHan Yoon, Yong Hoon Kim, Yun-Hyeong Cho, Woong Chol Kang, Weon Kim, Young-Hyo Lim, HyeonCheol Gwon, WoongGil Choi, Do-Sun Lim, Jung-Joon Cha, Hyung Joon Joo, Jae Hyoung Park, Soon Jun Hong, Tae Hoon Ahn, Byeong-Keuk Kim, WonYong Shin, Sung Gyun Ahn, JungHan Yoon, Yong Hoon Kim, Yun-Hyeong Cho, Woong Chol Kang, Weon Kim, Young-Hyo Lim, HyeonCheol Gwon, WoongGil Choi, Do-Sun Lim

Abstract

Although dual antiplatelet therapy is essential for patients who undergo percutaneous coronary interventions, the risk of bleeding remains an unsolved problem, and there is limited information on the potential relationship between genetic variants and major bleeding. We analyzed the correlations between four major single nucleotide polymorphisms (CYP2C19, ABCB1, PON1, and P2Y12 G52T polymorphisms) and clinical outcomes in 4489 patients from a prospective multicenter registry. The primary endpoint was major bleeding, defined as a Bleeding Academic Research Consortium ≥ 3 bleeding event. The allelic frequencies of ABCB1, PON1, and both individual and combined CYP2C19 variants did not differ significantly between patient groups with and without major bleeding. However, the allelic frequency of the P2Y12 variant differed significantly between the two groups. Focusing on the P2Y12 G52T variant, patients in the TT group had a significantly higher rate of major bleeding (6.4%; adjusted hazard ratio [HR] 2.51; 95% confidence interval [CI] 1.08-5.84; p = 0.033) than patients in the other groups (GG [2.9%] or GT [1.9%]). Therefore, the TT variant of the P2Y12 G52T polymorphism may be an independent predictor of major bleeding.Trial registration: NCT02707445 ( https://ichgcp.net/clinical-trials-registry/NCT02707445?term=02707445&draw=2&rank=1 ).

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Time-to-event curves through 1 year for major bleeding according to the P2Y12 G52T variant.
Figure 2
Figure 2
Flow chart.

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